Abstract

Background

Adult renal epithelial neoplasms are a heterogeneous group with varying prognosis
and outcome requiring sub-classification.

Methods

Cases of renal cell carcinoma (RCC) in a 10 years period were analyzed with regard
to the clinical features and histology. Sections were reviewed by four pathologists
and the discordant cases were resolved with the help of Hale's colloidal iron stain,
vimentin, CK 7, and vinculin immunostains and electron microscopy.

Results

Amongst the total of 278 cases, clear cell renal cell carcinoma was the commonest
tumor with 74.8% cases, followed by papillary RCC 12.2%, chromophobe RCC 7.9%, oncocytoma
1.8%, and one case of collecting duct RCC. Eight cases were of sarcomatoid renal cell
carcinoma. In 28/278 cases, diagnoses varied amongst the four pathologists and the
discordance was resolved by Hale's colloidal iron stain, CK7 immunostain and electron
microscopy. Vimentin and vinculin did not contribute much in differentiating subtypes
of renal cell carcinomas. Relative incidence of sub-types of RCCs was compared with
other series

Conclusion

To accurately subclassify renal cell carcinomas, simple ancillary techniques would
possibly resolve all difficult cases. The relative incidence of sub-types of renal
cell carcinoma is relatively consistent the world over. However, in India, RCCs afflict
the patients two decades earlier.